Boudoulas, Konstantinos D

Boudoulas, Konstantinos D is an individual health care provider with primary practice located at 410 W 10Th Ave Fl 1 , Columbus OH 43210-1240. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Boudoulas, Konstantinos D can be contacted via phone (614) 293-7677.

Contact Information

Primary practice address
410 W 10Th Ave Fl 1 Columbus OH 43210-1240
Fax: (614) 293-1456
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 35.094280 Ohio
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 35094280 Ohio

Profile Details

NPI number 1003976507
LBN Legal business name Boudoulas, Konstantinos D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated May 25th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003976507 NPPES
Ohio MEDICAID 2997119

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